Questions and Answers
After a patient undergoes a thoracentesis, the obtained pleural fluid is clear with a slight straw color. This fluid is most likely the result of:
The respiratory therapist is calibrating a spirometer and checking the volume with a 3.0-liter super syringe. The volumes recorded are 2.85L, 2.8L, and 2.8L. Based upon the information obtained, which of the following is a correct statement?
Which of the following is an indication for high-frequency jet ventilation?
What treatment should the respiratory therapist recommend for a 43 y/o female patient who is unresponsive after a total abdominal hysterectomy?
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What is the normal VD/VT ratio for a patient breathing room air?
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All of the following could cause a patient's right hemidiaphragm to be elevated, EXCEPT:
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Which of the following would most likely indicate that a 2 y/o child with croup is ready for extubation?
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Which of the following should the respiratory therapist monitor for a patient who is experiencing nausea and vomiting and has been started on Lasix?
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While instructing a patient prior to a vital capacity maneuver, the RT should direct the patient to:
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These results from a 77 y/o male patient are most consistent with which of the following: shortness of breath, fine basilar crackles, +2 pitting edema, and a chest X-ray with a butterfly pattern?
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What formula will determine the total flow being delivered to a patient with a 28% venturi mask running at 6 L/min?
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What should the respiratory therapist do for a patient with end-stage pulmonary fibrosis who experiences increased WOB and shortness of breath while receiving O2 at 2L/min via a transtracheal oxygen catheter?
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What should the respiratory therapist check to restore a normal waveform on the arterial line graphic?
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What should the respiratory therapist conclude if a patient on mechanical ventilation experiences a significant rise in heart rate and a severe fall in blood pressure after increasing PEEP to 15 cm H20?
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Study Notes
Thoracentesis and Pleural Fluid
- Clear, straw-colored pleural fluid post-thoracentesis indicates Congestive Heart Failure (CHF).
Spirometer Calibration
- Recorded volumes of 2.85L, 2.8L, and 2.8L suggest spirometer may have a leak.
High-Frequency Jet Ventilation
- Indicated for Bronchopleural Fistula; utilizes mean airway pressures and low tidal volumes to optimize oxygenation without worsening fistula.
Post-Anesthesia Care
- For an obtunded patient post-abdominal hysterectomy, inserting an oropharyngeal airway (OPA) is recommended due to unresponsiveness.
Ventilation Ratios
- Normal VD/VT (dead space to tidal volume) ratio for room air breathing is 20-40%.
Elevated Right Hemidiaphragm Causes
- Right-side hyperlucency with absent vascular markings suggests pneumothorax, not an elevated diaphragm.
Extubation Readiness in Pediatric Patient
- Breath sounds around the tube on auscultation indicate potential readiness for extubation in a intubated 2-year-old with croup.
Monitoring After NGT and Lasix
- Serum electrolytes must be monitored due to potential fluid loss with Lasix administration.
Vital Capacity Maneuver Instructions
- Instruct patient to inhale to Total Lung Capacity (TLC) then exhale to Residual Volume (RV) during vital capacity maneuver.
Pulmonary Edema Indicators
- Symptoms of shortness of breath, fine basilar crackles, +2 pitting edema, and a butterfly pattern on chest X-ray suggest pulmonary edema and CHF.
Total Flow with Venturi Mask
- Total flow delivered with a 28% Venturi mask at 6 L/min is calculated as 6 x 11 (flow factor = 11).
Transtracheal Oxygen Issues
- Increased work of breathing (WOB) and shortness of breath in a patient on transtracheal oxygen necessitate flushing the device with isotonic saline.
Dampened Waveform on Arterial Line
- To restore normal graphic on arterial line monitoring, check the transducer dome for air bubbles.
PEEP Study Results
- A significant rise in heart rate and drop in blood pressure at increased PEEP suggests the patient is experiencing hypovolemia.
Incentive Spirometry in Post-Op Patients
- Diminished breath sounds at lung bases and decreased inspiratory capacity post-thoracotomy may indicate complications needing further evaluation.
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Prepare for your NBRC exams with this set of practice flashcards. Each card presents a scenario or question relevant to respiratory therapy, with key concepts and definitions for effective review. Ideal for students and professionals looking to enhance their knowledge and exam readiness.